ĐẶC ĐIỂM CẮT LỚP VI TÍNH VÀ MỐI LIÊN QUAN VỚI KẾT QUẢ ĐIỀU TRỊ Ở BỆNH NHÂN NHỒI MÁU NÃO CÓ HẸP ĐỘNG MẠCH CẢNH ĐOẠN NGOÀI SỌ

Abstract

Background: Extracranial internal carotid artery stenosis is a significant risk factor, contributing to approximately 10–20% of ischemic strokes caused by large artery atherosclerosis. In the acute setting, non-contrast computed tomography (CT) of the brain plays a central role in the initial evaluation of these patients. Objectives: To describe the computed tomography characteristics and evaluate their association with clinical outcomes in ischemic stroke patients with extracranial internal carotid artery stenosis. Materials and methods: This was a descriptive cross-sectional study conducted on 46 patients diagnosed with ischemic stroke and extracranial internal carotid artery stenosis, who were admitted to and treated at Can Tho S.I.S General Hospital between September 2022 and August 2023. Results: The study included 46 ischemic stroke patients associated with extracranial carotid artery stenosis, with a mean age of 64.72 ± 15.84 years. Cranial computed tomography (CT) findings revealed that the majority of patients had multiple infarcts (84.8%) and no evidence of chronic infarcts (80.4%). Infarct locations were predominantly distributed across multiple brain regions (91.3%), with the highest incidence observed in the middle cerebral artery (MCA) territory (37%). At one month post-discharge, outcomes assessed using the modified Rankin Scale (mRS) were equally distributed between favorable and unfavorable prognoses. There were no statistically significant differences between the favorable and unfavorable outcome groups regarding age, sex, number of new or old infarcts, infarct location, or affected vascular territory (p > 0.05). However, the National Institutes of Health Stroke Scale (NIHSS) scores were strongly correlated with prognosis, with lower NIHSS scores associated with a significantly higher likelihood of favorable recovery (p < 0.001). Conclusion: Patients with ischemic stroke and extracranial internal carotid artery stenosis commonly exhibited multiple new infarcts with widespread distribution, predominantly affecting the middle cerebral artery territory on brain computed tomography. The NIHSS score at admission was strongly associated with clinical outcomes at one month.